3
177 dinning protestations against its abuse are required before he can be made to relinquish his hobby. I have been much amused by observing in your Journal how one practi- tioner swears that nothing but nitrate of silver can cure sore nipples ; another, that almond oil, hot water, and borax, are the only specifics. For my part, I have had some little experience in nipple excoriations, having seven large parishes under my care, and, really, I never, until the publication of Mr. Farr’s letter, felt sure of curing sore nipples when consulted by any female la- bouring under this most troublesome com- plaint. Nay, to tell the truth, I always felt as though I were quacking my patients, for I had found every remedy fail, and Mrs. Nature generally took the case, to my great delight, out of my hands. Since, however, I have tried the catechu, I have never found it fail. I do not order the nipple to be cleansed from the catechu previous to suck- ling the child. "Keep it constantly applied until it is well," are my orders, and in about a week I find it well. One woman, the other day, said, " I am afraid it will break out again, for it can’t be properly cured in the time," thinking the rapidity of the healing incompatible with a healthy cure. It may be said that this is my hobby. Be it so. I wish all my hobbies terminated as well. Yours truly, J. HOPGOOD, M.R.C.S.&L.A.H. Bampton, Devon, Oct. IS, 1842. HULL SCHOOL. THE " Hull and East-Riding School of Anatomy and Medicine" is said by a friend of the school to be very inadequately sup- ported, and to be labouring under " a large debt which has been incurred in the erection of a neat and commodious building," but its means "do not appear to warrant the enterprising proprietors in extensively adver- tising." The formation of the medical school was first suggested by Dr. Alderson, and in 1831 his son, Dr. James Alderson, with Messrs. Craven and Wallis, succeeded in establishing a school, which has since sent forth a number of well-informed practitioners. There is an hospital in Hull stated to be " a magnificent ornament to the town, and a library of about one thousand volumes con- nected with it, open to students and sub- scribers." 11’e are sorry to hear that the speculation of the school is not successful, for if students must go through the oppressive curricula of the coMeges and halls, they had better do so at home, in the country towns, than in London ; and if the regulations of the provincial hospitals be liberal, disease may generally be studied there much more care. fully, and less expensively, than amid the bustle of a London charity. LANCET. London, Saturday, October 29, 1842. MONEY-SYSTEM AT THE HOSPITALS. IN the various systems of education which are pursued in this country, there is one striking defect which appears to signalise the whole of them, namely, THE ABSENCE OF SUFFICIENT REWARDS FOR MERITORIOUS ACTIONS. Precisely the same thing is to be found pervading almost the whole of our social in- stitutions. The arrangements of society, having their origin either in custom, or in Parliamentary law, offer few inducements to high intellectual exertion, the ordinary sti- mulus being simply lucrative gain. Had the Legislature of this kingdom exhi- bited a parental care in establishing and governing our medical scholastic institutions, great and ennobling would have been the result, and we should not at this epoch have been called upon to denounce the grovelling and low-minded proceedings of our medical corporations. f Several times we have had to deplore that the profession has not been true to itself; yet, notwithstanding that painful admission, and the still more painful fact, we fully be- lieve that no such charge would have been applicable to the profession, had it possessed the power to originate and regulate its own proceedings. Minds which for years have been engaged in scientific inquiries-minds which have been thoroughly drilled in the arduous pur- suit of a knowledge of medicine, must, in- evitably, be the best capable of judging what are the most efficient modes of con- ducting such investigations, and of forming correct opinions as to the value of the infor- mation that is acquired. Equally natural is it to believe that judgments thus formed must be the most competent to create, and give effect to, every proper inducement to exertion on the part of youthful students. Systems thus formed would leave nothing to chance-would not render professional

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177

dinning protestations against its abuse arerequired before he can be made to relinquishhis hobby. I have been much amused byobserving in your Journal how one practi-tioner swears that nothing but nitrate ofsilver can cure sore nipples ; another, thatalmond oil, hot water, and borax, are the

only specifics. For my part, I have hadsome little experience in nipple excoriations,having seven large parishes under my care,and, really, I never, until the publication ofMr. Farr’s letter, felt sure of curing sore

nipples when consulted by any female la-bouring under this most troublesome com-plaint. Nay, to tell the truth, I always feltas though I were quacking my patients, forI had found every remedy fail, and Mrs.Nature generally took the case, to my greatdelight, out of my hands. Since, however,I have tried the catechu, I have never foundit fail. I do not order the nipple to becleansed from the catechu previous to suck-ling the child. "Keep it constantly applieduntil it is well," are my orders, and in abouta week I find it well. One woman, theother day, said, " I am afraid it will breakout again, for it can’t be properly cured inthe time," thinking the rapidity of the healingincompatible with a healthy cure. It maybe said that this is my hobby. Be it so. Iwish all my hobbies terminated as well.Yours truly,

J. HOPGOOD, M.R.C.S.&L.A.H.

Bampton, Devon, Oct. IS, 1842.

HULL SCHOOL.

THE " Hull and East-Riding School ofAnatomy and Medicine" is said by a friendof the school to be very inadequately sup-ported, and to be labouring under " alarge debt which has been incurred in theerection of a neat and commodious building,"but its means "do not appear to warrant theenterprising proprietors in extensively adver-tising." The formation of the medical schoolwas first suggested by Dr. Alderson, and in1831 his son, Dr. James Alderson, withMessrs. Craven and Wallis, succeeded inestablishing a school, which has since sentforth a number of well-informed practitioners.There is an hospital in Hull stated to be " amagnificent ornament to the town, and alibrary of about one thousand volumes con-nected with it, open to students and sub-scribers." 11’e are sorry to hear that the

speculation of the school is not successful,for if students must go through the oppressivecurricula of the coMeges and halls, they hadbetter do so at home, in the country towns,than in London ; and if the regulations of theprovincial hospitals be liberal, disease maygenerally be studied there much more care.fully, and less expensively, than amid thebustle of a London charity.

LANCET.

London, Saturday, October 29, 1842.

MONEY-SYSTEM AT THE HOSPITALS.

IN the various systems of education whichare pursued in this country, there is one

striking defect which appears to signalisethe whole of them, namely, THE ABSENCEOF SUFFICIENT REWARDS FOR MERITORIOUS

ACTIONS.

Precisely the same thing is to be found

pervading almost the whole of our social in-stitutions. The arrangements of society,having their origin either in custom, or in

Parliamentary law, offer few inducements tohigh intellectual exertion, the ordinary sti-mulus being simply lucrative gain.Had the Legislature of this kingdom exhi-

bited a parental care in establishing and

governing our medical scholastic institutions,great and ennobling would have been theresult, and we should not at this epoch havebeen called upon to denounce the grovellingand low-minded proceedings of our medical

corporations.

f Several times we have had to deplore that

the profession has not been true to itself;yet, notwithstanding that painful admission,and the still more painful fact, we fully be-lieve that no such charge would have beenapplicable to the profession, had it possessedthe power to originate and regulate its own

proceedings.Minds which for years have been engaged

in scientific inquiries-minds which have

been thoroughly drilled in the arduous pur-suit of a knowledge of medicine, must, in-evitably, be the best capable of judgingwhat are the most efficient modes of con-

ducting such investigations, and of formingcorrect opinions as to the value of the infor-mation that is acquired. Equally natural isit to believe that judgments thus formedmust be the most competent to create, and

give effect to, every proper inducement toexertion on the part of youthful students.

Systems thus formed would leave nothingto chance-would not render professional

Page 2: LANCET

178 WORKING OF « THE SYSTEM AGAINST MERIT.

offices and rewards a wheel-of-fortune into possessed superior abilities, but simply be-which every dirty and corrupt hand might cause they could exercise superior familydip with a fair chance of obtaining a valu- and hospital influence. The places, there-

able prize. Had the elections to medical fore, which they are allowed to fill were ob-

institutions been regulated by the profession, tained, not through the instrumentality ofwho can believe that the great majority of the intellectual capacity, but either from a foul

persons whose names we exposed in the last system of patronage, or the direct influence

LANCET, would everhaveobtained prominent of money.and important surgical offices? The ques- With such a system as this at work,tion absolutely involves an absurdity which spreading its pestiferous poison over the

is calculated to produce a smile on every whole range of our medical institutions,serious countenance, where is that encouragement held out to

A system, then, which enables such per- genius which is calculated to bring into playsons to obtain distinctions, when acknow- the best directed exertions of the juvenileledged merit and ability remain depressed student, or the practitioner in medicine? As.

and unrewarded, ought to be denounced by suredly it will not be contended that the

every honest medical critic. In conformity most important offices in the professionwith the present corrupt and detestable prin- should remain uncontributary to our stores of

ciples of medical government and election, medical information. That they are, for thethe rewards are offel’ed to knavery and im- most part, obtained by incompetent persons,becility, and, in reality, are obtained by is certain. Equally certain is it that theythem. Such is THE SYSTEM, as is proved by offer no inducements to men of genius whoinnumerable facts ; such is THE SYSTEM, as cannot back their pretensions by the knavishmust be acknowledged by every impartial machinery with which those offices are

observer who has perused the names of the worked. None of these things can be de-

present occupants of medical offices which nied, even by the most callous and hardenedwe last week submitted to the view of the advocate of the existing electoral system.profession and the public. There would be At, then, the STARTING POINT in medical

great illiberality in asserting that several of education, the arrangement is radically de-those gentlemen, in addition to the three we fective, because at the 1’eryfirst step the stu.named last week, are not well-qualified, dent’s mind should be directed to some greatpractical surgeons, and having, in eulogistic attainable object, that he may have a suffi-

terms, referred to the names of Mr. LisTOtv cient reward to keep steadily in view,-aand Mr. KEY, and having noticed, both reward that should prove a fit recompense

favourably and unfavourably, that of WIL- for his arduous labours,-not a mere merce-Lmaz LAWRENCE-favourably for his acquire- nary return, but one that should confer upon

ments, and unfavourably for the disreputable him, not only a substantial income, but, inuse he has made of them,-it would be unjust the instance of a highly-gifted mind, the farof us to refrain from stating that Mr. more gratifying trophies of distinction and

QUAIN, Mr. GREEN, and Mr. MAYO, are renown.

known to the profession as surgeons who If, then, THE SYSTEM, in its very germ, be

possess very considerable scientific attain- bad,-if the root take hold and fasten in a

ments. It would be wrong, also, to refrain pernicious soil,-what is the fruit which thefrom mentioning the name of that diffident cankered tree must and does produce ? We

gentleman, GEORGE JAMES GUTHRIE, in the have already seen that the offices are not

same category. But the essence of our attainable by means of intellectual labour, andcomplaint consists in this, that the offices that to exertions of such an order they offerwhich the surgeons of our hospitals occupy no inducements.were acquired by them,-not because they " Oh, stay," exclaims the advocate o *

Page 3: LANCET

179MR PAYNE. THf CORONER.

the present system of election in our hospi-tals. 11 Reflect what the surgeons of those" institutions have done after they have ob-tained their offices. Look at the names of

" Sir ASTLEY COOPER, ABERNETHY, CLINE," CHESSELDEN, and POTT."To be sure. We may look at them, and

rejoice that such men have existed. There

are, however, others, of a very different

stamp,-names that are not quite so agree-able to look upon, as may be discovered too

quickly on referring to those of the VINCENTS,the SCOTTS, the STANLEYS, et hoc genus omne.Sir ASTLEY COOPER was, really, a splendidsurgeon. But, did the system of which heformed so distinguished an ornament, tend, inany respect, to produce, or even to exhibit,the powers of his mind ? On the contrary,AsTLEY COOPER obtained his appointment assurgeon to Guy’s Hospital, in the objection-able and obnoxious mode of his successors,

and he subsequently acquired his renown, byindefatigable labour, and the exercise of an

unusually active and powerful understand-

ing. The elevation of Mr. ABERNETHY to

his offices in St. Bartholomew’s Hospital,was also in conformity with that disgustingrevolving action which has thrown up into

prominent places his imbecile successors,and the name of that gentleman may be cited,both to the glory and the shame of the sys-tem. He was endowed with a peculiarlyoriginal mind. He had great intellectual

capabilities, was eloquent as a speaker,lucid as a writer. Yet, what were his

achievements in science in comparison withthe opportunities which the walls of St. Bar-tholomew’s Hospital afforded him ? The

system of which he forms a part allowed himeither to exert himself, or to fall into a stateof repose, precisely as he listed. There was

nothing to stimulate him, or to call his facul-ties into activity. He exerted himself justas he might be influenced by, or as his mind

might receive an impulse from,his own privateinterests. He was lazy. There were no com-

petitions, no concours, to urge or whip himinto action. Hence, he slumbered, and, in’the chair of surgery, doled out, continuously,

during a long series of years, the same unim-

proved series of lectures, in a great depart-ment of his profession.Thus, to the laborious student, the offices

in our hospitals hold out no inducement to

exertion. Among the surgeons who acquirethose offices by less reputable means thanmerit, they produce no qualities which sti-mulate to activity. Either to the youthful,or to the matured, mind, there is nothing tobe found in them which demands or secures

gt’eat intellectual exertions. We ask of

every candid thinker whether such a systemought to be continued, and whether medicalreformers are unreasonable in struggling forits annihilation?

But, in all probability, its odious nature

cannot be fully and adequately understoodwithout placing it in contrast with the modein which the elections are made in the Hospi-

TALS OF PARIS,—a contrast which we shalltake an early opportunity of fully placingbefore the medical profession of this country.

THE Coroner for the city of London hasaddressed the following letter to the Editor

of The Times :—

" CORONER’S LAW.

" To the Editur of ’ The Tiines.’

" Sir,—After having so recently had occa-sion to correct an error of Mr. Wakley’s inpoint of law, I am sorry so soon to have rea-son to correct an error of his on matter of

fact, as I had hoped that experience (whichworks wisdom on a certain class of the

community) would have made him morecautious.

" In the case of the inquest on Dr.Kenney, reported in your paper of to-day, Isee that the Middlesex Coroner has been forthe third time indulging in some observationsrespecting the case of the girl who threwherself from the Monument. He is reportedto have said, that on the occasion of thatinquest a surgeon was examined, and whenthe fact was ascertained that the fall hadbeen the cause of the poor girl’s death, fur-ther medical evidence was gone into, whichset forth to the world that she had not been

pregnant, but had departed from the pathsof virtue. Instances of this kind when theyoccurred tended to make a coroner’s inquesta public nuisance, instead of a public benefit.’